A left ventricular aneurysm may develop due to coronary heart disease or after a heart attack. This is a protrusion of the heart wall, which is associated with cicatricial changes in this area. There is no more muscle tissue in this area, only connective tissue that cannot contract. Aneurysms can be successfully treated in modern Cardiovascular Surgery Centers. In cardiology and vascular surgery, aneurysm plastic surgery is increasingly performed simultaneously with coronary artery bypass grafting (CABG).
- Who may need surgery treatment for a left ventricular aneurysm?
- How are CABG and left ventricular aneurysm repair performed?
- Where are CABG and plastic repair of left ventricular aneurysm performed?
Who may need surgery treatment for a left ventricular aneurysm?
A left ventricular aneurysm can be eliminated with surgery or conservative therapy. Medicines cannot eliminate the aneurysm because they only reduce symptoms. Therefore, in severe cases, patients require surgery treatment. Indications for a surgical intervention are the following:
- left ventricular dilatation;
- ejection fraction below 20%;
- about 35% of the area of the ventricle contracts incorrectly or does not contract at all;
- detected arrhythmia with symptoms of angina pectoris or heart failure;
- signs of myocardial blood supply deficiency during stress tests.
In cardiac surgery of aneurysm, simultaneous operations are often performed to eliminate several diseases, for example, the treatment of coronary heart disease and acquired heart defects. In the case of ventricular CABG with an aneurysm plastic repair, doctors treat one heart disease: they eliminate the consequences of a heart attack, eliminate the symptoms of myocardial ischemia, and prevent recurrent heart attacks.
How are CABG and left ventricular aneurysm repair performed?
CABG and plastic repair of left ventricular aneurysm are performed during the same surgical procedure. The operation can be performed with or without a heart-lung machine, depending on the technique used. Operations are most often performed by connecting the patient to a heart-lung machine. Despite this, the heart is beating. It is not stopped because a doctor needs to understand which parts of the myocardium are contracting and which are not to remove scar tissue and preserve normal muscle.
Different techniques can be used to repair left ventricular aneurysm:
- aneurysm plastic repair with Jatene and Dor techniques, which are the main operations used in developed countries;
- linear plastic surgery in the Mickleborough modification;
- the SAVE procedure, also known as the Pacopexy technique.
In any case, the task of the physicians of the Department of Cardiosurgery is to remove the scar tissue as much as possible, preserve normal muscle tissue, and close the defect with a patch. At the same time, it is important that the shape of the left ventricle be restored, as close as possible to the normal ellipsoid.
During the same operation as for the treatment of left ventricular aneurysm, CABG is performed to restore blood supply to the myocardium. Doctors take the patient's thoracic artery and form new blood vessels from it that carry blood from the aorta to the coronary arteries, but the blood flows into them beyond the narrowing.
As a result of the operation, the function of the heart improves, its rhythm normalizes, and the ejection fraction increases. The patients feel better. In most cases, they no longer suffer from angina attacks or manifestations for heart failure. The operation also helps to increase life expectancy, as it reduces the risk of death from ventricular arrhythmia, progression of heart failure, and recurrent infarction.
Where are CABG and plastic repair of left ventricular aneurysm performed?
You can get left ventricular treatment in one of the countries with a high level of medicine. You are welcome to use the Booking Health website. On our website, you can find the best Cardiac Surgery Centers for treatment abroad and see the current cost of treatment. You can compare the cost of treatment in different Departments of Cardiovascular Surgery and choose the option at the best price.
When you make your appointment for CABG and plastic repair of left ventricular aneurysm through the Booking Health service, the cost of treatment will be lower for you. Prices for services in the field of cardiology will be reduced due to the absence of additional taxes for foreign patients.
If you make an appointment for your treatment abroad through the Booking Health website, you can expect that the initial cost of treatment will not increase after the start of your medical care program. The price will remain the same even if additional medical services are required, as you will receive insurance to cover unexpected expenses.
The Booking Health specialists will arrange your treatment abroad at one of the best Cardiology Centers. We will contact the hospital administration and schedule an appointment for you on your preferred dates, translate medical records, etc. The Booking Health specialists will meet you at the airport and take you to the hospital by car. After the completion of your medical care program, we will take care of organizing a return transfer.
The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Vadim Zhiliuk. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
ECR - European Cardiology Review
JAHA - Journal of the American Heart Association